1. Field of the Invention
This invention relates to surgical devices and, more particularly, to devices for effecting the transmission of light for endoillumination, intraocular endoscopy, or laser application to intraocular tissue.
2. Discussion of the Related Art
The most widely accepted prior art means for performing intraocular surgery in the anterior segment of the eye comprise a variety of instruments designed for irrigation, ablation, cutting and removal of tissue. Separate instruments for irrigation, illumination and laser application are known, but they have the disadvantage of requiring multiple surgical openings in the eye and may be cumbersome to operate for the surgeon. Multiple surgical openings in the eye and multiple surgical instruments add to the risk of complications and increase the difficulty of the surgical procedure. Surgical instruments that combine water infusion, suction and light conducting elements in a single probe have been described, but they have the inherent physical limitations imposed by side-by-side conducting channels. Another problem that arises in the use of complex multiple-element surgical instruments is the cost and labor of repeated sterilization.
Examples of ophthalmic instruments of the type described are commercially available from Grieshaber & Co., Inc., 3000 Cabot Boulevard West, Langhorne, Pa. 19047. These are shown in company brochures under the title "The Grieshaber Light Source and Family of Accessories".
Recent reports of specific cases in which prior art instruments of the type described are used may be found in Arch Ophthalmol Vol. 111, July 1993: "Neodymium-YAG Laser Phacolysis of the Human Cataractous Lens" and Ophthalmology, Vol. 100, Number 7, July 1993: "Experimental Endoscopic Goniotomy". The former describes a performance of Nd-YAG laser phacolysis on a particular patient for the removal of a nuclear sclerotic cataract. The latter report describes the use of an endoscope coupled to another surgical instrument in experimental surgery on porcine cadaver eyes designed to lead to the use of a tiny endoscope attached to a goniotomy needle for the treatment of primary infantile glaucoma. Both of these arrangements are subject to the deficiencies described hereinabove.